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Depression: Insights Into Insomnia

Sleep deprivation is one of the many symptoms of depression, but Dr. Jason Drwal is here to shine some light on the subject.

By Jason Drwal, PhD

An aching back, a crack of thunder, a dream that I missed some important work deadline—all of these can snap my eyelids open from a sound sleep. Once I realize I’m awake, I feel the grogginess evaporating. Soon I’m infuriatingly alert.

This was my nightly struggle until I came to terms with reality: As a psychologist I was helping people with their insomnia, but not doing so well with my own.

Most nights I slept about four hours. Being a worrier didn’t help. I’d mentally tally how much I’d slept, ruminate about how tired I felt, and convince myself that insomnia was shortening my lifespan.

During the day, I was nodding off at my desk. I tried the strategies I recommended to patients, but after a day or two I’d get frustrated and tell myself I was just biologically programmed to wake at the drop of a pin. Sometimes I would listen to my wife’s rhythmic, deep breaths and I’d think, “This is so unfair.”

When I realized how grouchy I was acting and how stressed I felt, decided I had to do something. Attitude and acceptance have been my invaluable companions. Here are some interrelated insights that helped me:

Make peace with insomnia.

Internal struggle only deepened the cycle of poor sleep. Staring at the ceiling, I would bemoan and lament my restless mind, the pain in my shoulders, the worries about a presentation the next day. The more emotional I became, the more I woke up. When I accepted that sometimes I wouldn’t be able to sleep and sometimes my mind wouldn’t shut off, I stepped out of that cyclone. Sometimes I fall asleep and sometimes not, but at least I’m not upset about it.

Stop trying so hard to sleep.

As I fretted about being awake, I would try to will myself to sleep. The more I tried to control my thoughts, the more they acted like gremlins banging pots and pans in my head. I’ve learned that sleep has to be invited in and encouraged, not arm-wrestled into submission. Now if my mind is running wild, I tell myself that’s OK. Often, given patience instead of animosity, it will slow down enough for me to drift off.

Make sleeping matter less.

Good sleep is undeniably important. Yet the more I made sleep the center of my mental universe, the more worried, obsessed, and irritated I became about the possible consequences of not getting enough. What I’ve learned is that I can function even if I’m tired. I can make it through the day, and even have periods where I feel perfectly alert. I can reassure myself that if I don’t have a good night, I’ll still be just fine.

Create attractive alternatives.

The standard recommendation when you can’t fall asleep (or back asleep) is to get up and do something else for a while. But at 3 a.m. my body feels like lead and my mind is like a flickering lightbulb that refuses to go out. What if I waited another 10 minutes? Maybe I’d drift off! What finally helped me was creating a list of things that were more enjoyable than lying in bed: read a book, watch a show, play a game on my phone, meditate. That made rolling out of bed feel like less of a punishment. When I was finally tired again, I could climb back into bed with much better odds of sleeping.

Look at your larger issues.

Sleep management is life management. For years I failed to appreciate the fact that when we try to change one habit, other habits pull us in the opposite direction. Stress, perfectionism, obsessiveness, caffeine addiction, negative thinking, back pain—all of these affected my sleep. Making small changes in other areas—managing stress more effectively, addressing my tendency to ruminate on mistakes, cutting back on coffee and so on–finally my efforts at sleeping improvement to stick.

Roll with relapses.

I wish I could say that I’ve conquered insomnia, but I haven’t. When I have a bout, though, it’s much easier to work through. Getting back to normal sleep takes only a few days—and when I can’t fall asleep, I no longer feel hopeless or distressed.

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HEALTHY HABITS

Most of us don’t default to healthy habits. It takes planning and effort, and sometimes a surge of self-discipline, to eat right, exercise, get the sleep we need, and stay on top of work and life tasks. Establishing new habits, let alone purging bad ones, can require major effort, especially if we are also struggling with depression or anxiety. What are some good habits that you've formed and how did you build them?